REVENUE CYCLE SPECIALIST

Job Description

Job Title: Revenue Cycle Specialist – Behavioral Health

Location: Infinite Recovery, Buda, TX

FSLA: Non-Exempt

Job Summary:

We are seeking a knowledgeable and detail-driven Revenue Cycle Specialist to join

our behavioral health finance team. The ideal candidate has a solid background in all

aspects of the revenue cycle; from verifying insurance to claim submission, payment

posting, denial management, and client services. Shows they are committed to

maintaining accuracy and compliance across all financial workflows.

Key Responsibilities:

Verify patient insurance eligibility and benefits prior to services.

Communicate with clinical and admissions staff to ensure accurate insurance

information is captured.

Post insurance and patient payments, adjustments, and denials.

Reconcile remittances with patient accounts and identify discrepancies.

Work with accounting and finance teams for month-end close and reporting.

Analyze and appeal denied or underpaid claims in a timely manner.

Follow up with payers on unpaid or aged claims.

Work collaboratively with patients and families on outstanding balances and

payment arrangements.

Maintain compliance with HIPAA, payer policies, and federal/state regulations.

Document all account activity accurately in the billing system and patient records.

Work closely with clinical staff, intake, and case management teams to resolve

billing issues.

Generate and analyze revenue cycle reports to identify trends and opportunities

for improvement.

Participate in team meetings to provide insight into revenue performance and

process enhancements.

Monitor and manage leave timelines, durations, and return-to-work dates.

Maintain detailed and accurate case notes for each leave request

Verify employee eligibility for FMLA, STD, and other types of leave based on

company policy and federal/state laws.

Collect, review, and process medical documentation and certification forms in

compliance with applicable regulations.

Qualifications:

High school diploma or equivalent (required); associate degree or higher in

healthcare administration or related field (preferred).

2+ years of experience in medical billing or payment posting (behavioral health

experience strongly preferred).

Knowledge of insurance carriers, EOBs/EFTs, and denial codes.

Experience with practice management software and electronic health records

Proficiency in Microsoft Excel and other basic office software.

Strong attention to detail, analytical skills, and ability to manage time efficiently.

Excellent communication and customer service skills.

The job duties listed in this job description may not be inclusive of all requirements of this position. Other duties may be assigned by your supervisor.

SUPERVISORY RESPONSIBILITIES

This job has no supervisory responsibilities.

COMPETENCIES

To perform the job successfully, an individual should demonstrate the following competencies:

Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics.

Customer Service - Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments.

Communications - Expresses ideas and thoughts verbally; expresses ideas and thoughts in written form; exhibits good listening and comprehension; keeps others adequately informed; selects and uses appropriate communication methods.

Teamwork - Balances team and individual responsibilities; exhibits objectivity and openness to others' views; gives and welcomes feedback; contributes to building a positive team spirit; puts success of team above own interests; able to build morale and group commitments to goals and objectives; supports everyone's efforts to succeed.

Ethics - Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and principles; upholds organizational values.

Judgement - Displays willingness to make decisions; exhibits sound and accurate judgment; supports and explains reasoning for decisions; includes appropriate people in decision-making process; makes timely decisions.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

LANGUAGE SKILLS

Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers. Ability to communicate effectively through email. Ability to effectively present information to top management, public groups, and/or boards of directors.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

REASONING ABILITY

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

COMPUTER SKILLS

To perform this job successfully, an individual should have knowledge of Microsoft Office (Word, Excel and Outlook) as well as CRM platforms, specifically Sales Force.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this Job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk and sit. The employee is occasionally required to use hands to finger, handle, or feel; reach with hands and arms and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision and distance vision.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The noise level in the work environment is usually moderate.

Full-time